2010年东莞市手足口病病原监测分析

目的了解东莞市手足口病病原谱构成及其流行特征。方法采用实时荧光PCR检测2010年手足口哨点监测医院上送的标本,应用Excel和SPSS分析。结果380例病原阳性病例中,EV71（占29.47%）所占构成比略高于CoxA16（占24.47%）,未分型肠道病毒占46.05%。病原感染构成比无性别差异,以5岁以下人群感染为主（占96.72%）。EV71与CoxA16在0~1岁人群感染构成比最低（各为14.43%与11.34%）,在1～5岁人群感染构成比较稳定（占36.13%）,6岁后以EV71感染为主（占40.0%）;3～7月以EV71与CoxA16流行为主,其中6～7月以EV71为主（约占47.91%）;8月后以未分型感染为主,其中10～12月感染构成比最高（占87.50%）;各监测点EV71与CoxA16呈交替流行,未分型肠道病毒占较大比例。病例样品检出率较高（达89.41%,380/425）,以粪便为主（占87.29%）,其检出率明显高于肛拭子（73.08%）。结论东莞市手足口病病原谱构成与流行在人群年龄、时间、地域方面均呈动态变化,以CoxA16伴随EV71流行为主,其它未分型肠道病毒也占相当比重。

Results of monitoring of hand-foot-mouth disease in Dongguan city in 2010

Objective To investigate the pathogens and prevalent features of hand-food-mouth disease（HFMD） in Dong- guan city. Methods Excel and SPSS were used to analyze the data of HFMD cases detected by real- time RT-PCR in Dong- guan in 2010. Results The enterovirus in 380 samples of clinical HFMD cases were detected, the positive rate of EV71 and CoxA16 accounting for 29.12% and 23.35% respectively（x2=2.839,P=0.092 ）, and other types accounted for 47.80%. The pro- portion of antigen types did not show gender difference. The cases under 5 years accounted for 96.72%, and the proportions of EV71 and CoxA16 were the lowest in the cases younger than 1 years （74.23%） , while 36.13% of the eases aged from 1 to 5 years infected with EV71 and CoxA16, the infection rate of EV71 in children aged over 6 years accounted for 40%）. EV71 and CoxA16 were prevalent in the months between march and July.EV71 was accounted for 47.91% in June and July, while undif- ferentiated types prevailed after August. EV71 and CoxA16 were prevalent alternatively in each monitoring sites and undifferen- tiated types accounted for a large proportion.The total detection rate of the samples was 89.41%（380/425） and mainly from stool samples accounted for 87.29%, higher than that of anal swabs. Conclusions Dynamic changes age, month and area were ob- served in pathogen constitution of HFMD in Dongguan City. EV71 and CoxA16 are the main pathogens prevalent in this city and other undifferentiated types also accounted for quite s small proportion.